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Streptococcal sepsis

Streptococcal sepsis or septicemia is a severe infectious disease with high mortality, which is characterized by an already existing primary streptococcal infection, which must necessarily have spread hematogenously, that is, the bacteria must have penetrated the bloodstream, in as a result of which the damage to multiple organs occurred and the spontaneous bad evolution of the primary infection took place.

The cause of the disease is streptococci, which are gram-positive streptococci bacteria. Among the distinguishing features of streptococcal sepsis, as mentioned above, is bacteremia and the absence of metastases.

It is characterized by a severe clinical course, which is determined by the causative agent’s ability to form hemolysin, necrotoxin, fibrinolysin, proteolytic enzymes and other damaging factors.

Perhaps the most severe course is sepsis due to purulent streptococci. Other possible causes of this type of septicemia are faecal and greening streptococci.

Most often, this disease occurs with the formation of purulent foci in patients who were previously on immunosuppressive or steroid therapy.

Sepsis, the causative agent of which are these bacteria, i.e. purulent streptococci, usually proceeds rapidly, causing a shock reaction or in the form of septicopemia.

In the majority of cases, the sick are not contagious to others, and septicemia can be due to both an internal /existing/ and an endogenously induced infection, most often occurs in hospital conditions.

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Sepsis is generally characterized by the presence of a primary infectious focus, for example in the respiratory tract, nasal cavities, throat and middle ear, in bone tissues, bacteremia and development are necessarily established.

What are the symptoms?

Specifically, streptococcal sepsis is characterized by a wide clinical polymorphism, and this applies both to its clinical manifestations and syndrome, and to its clinical progression.

Clinically, the disease can proceed in several ways:

• Rapid in the form of septicopemia with the formation of metastases;
• Acute infectious inflammation of the endocardium, in which purulent metastases are formed;
• Chronic form of inflammation of the endocardium, as in such cases most often greening streptococci and, much less often, faecal streptococci are isolated as the causative agent.
• Generalized formation of metastases in almost all organs.

The most characteristic clinical manifestations of the disease are:

• Increase in body temperature, accompanied by chills, and the rates of temperature rise are characteristic.
• Deteriorated general state of health with developing intoxication;
• Decrease in body weight;
• Painful sensations in the muscles and joints;
• Fatigue;
• Hallucinations are possible;
• The patient feels weak and sleepy or, on the contrary, is in a state of excitement, euphoria and shows signs of inadequacy .

Another typical clinical symptom of this type of sepsis is the increase in the size of the spleen and liver at the very beginning of the progression of the infectious disease.

Skin changes are very different, both in terms of their localization and in terms of their characteristic features. In sepsis caused by streptococci, specific lesions in the form of nodules, known as Osler’s nodules, are formed in most cases.

The patient’s breathing rate is accelerated, the heart muscle contracts faster than usual, but its tones are weak. Patients are predisposed to the development of arterial hypotension.

When this type of sepsis progresses, multiorgan dysfunctional syndrome develops. One of the most serious possible complications is the onset of septic shock.

Treatment of streptococcal sepsis

Even in case of suspicion of sepsis, the patient must be immediately hospitalized and in the intensive care unit of the medical facility, and antibiotic therapy with penicillins and aminoglycosides is prescribed.

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